Studies of offspring of chronic alcoholic women have revealed a pattern of malformation with accompanying brain dysfunction termed fetal alcohol syndrome. Prospective study of a cohort of 500 infants (selected from 1500 consecutive pregnancies) indicates that offspring of heavy social drinkers compared to controls had poorer learning on neonatal operant tasks and poorer habituation as well as more dysmorphic features suggestive of fetal alcohol syndrome, although some of these findings were confounded with a nicotine/alcohol interaction. Unusual brain findings similar to those found in offspring of chronic alcoholic mothers, were also found, although sample size was very small. The purpose of the present study is two-fold: (1) To re-examine the same cohort of 500 infants again at age 4 years to study the effects of heavy social drinking during pregnancy on cognitive and language development in offspring and to assess the predictive validity of the neonatal measures. (2) To develop a community-wide network for the referral of pregnant women with heavy alcohol use, particularly binge drinkers and those who have changed their drinking patterns during pregnancy. Through the cooperation of an interdisciplinary team of investigators, the effects of intra-uterine exposure to alcohol will be studied in terms of neonatal operant conditioning and sucking, sleep and activity states, Brazelton assessments, dysmorphology examinations, and 8-month Bayley exams. Neuropathology and embryology studies will be available when appropriate. Metabolic studies will enable evaluation of the effect of alcohol ingestion on maternal metabolism as well as the effect of maternal metabolism as an intervening variable in fetal damage. It is hoped that through the ascertainment of a larger sample of heavier-drinking women the alcohol/nicotine interaction will be clarified.